Provider Demographics
NPI:1821230756
Name:EDMONDS, SARAH VICTORIA (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:VICTORIA
Last Name:EDMONDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-1321
Mailing Address - Country:US
Mailing Address - Phone:541-966-1099
Mailing Address - Fax:
Practice Address - Street 1:823 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-1321
Practice Address - Country:US
Practice Address - Phone:541-966-1099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200141423RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health